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N <br />R <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org %'-Z'o <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM C ga I <br />PROJECTADDRESS L125.3t13 k�15 <br />rl <br />(jcn(1cLres�1<.0 lilt �� l "1'� Avr IuF L7tI1�SFGterS WA �1825$ <br />Owner Mail Address City StatelZip Phone <br />LA-25 34-3 b3tC <br />Yi�l Ci11lL1GL 1 ,c-, 1 kucic ,Jr, Fes) Uvcce-H L,-Y-N `-iS 2D3 <br />Tenant Mail Address City Stale/Zip Phone <br />Z6b <br />Lvos��I�t�� AL0.1-m 12S3S.LL$-\`2ILA (A 322 3-Z28 <br />Electrical Contractor Mail Address CRY State/Zip Phone <br />�IASh11Al2�ZC3 I`t 2-14 00 <br />State License Number Contract Price of Work <br />01•LL�,1-Gh i?ynt'-' Acr _f <br />Proposed Use of Building L Contact Person (Plan Review) <br />Description of Work to Be Done: �1'1S 1 -1-� ZOh O� jrryC :'�_ Loe-'L tilS r ('�i1 <br />2)1��tllLCLQ �In� S� lL�- t-'W1'1'1 Cbrolao-S _Ctj-U1�'eS CA6vit <br />Covinecil(DY) LUF 2 1 K AC QyVZ:11-01 5 <br />NOTE: WIRING IN NON -DWELLINGS IS REQUIRED TO FEE <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby certify that I have mad and examined this application and know the some to be We and <br />correct. All provisions of laws and ordinances governing this type of work will be completed <br />whether specified herein or not The granting of a permit does not presume to give aulhonty to <br />violate or cancel the pprovisions of any other state or local law regulating construction or the <br />do pemiance of constriction. That I am authorized by the owner of this pmpeM, to perform the <br />work for which application is made and/ comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />Signatu Dale C , <br />